So You’ve Decided to Tweet

As the new medical-academic year begins, I'm guessing a bunch of new interns will learn about how great FOAM is, and at the same time, get an orientation lecture on "threats to professionalism." Obviously I think there is a ton of potential benefit to using social media as a medical professional, and here are some of the ways I "maintain professionalism" (read: keep myself out of trouble).

One of my big keys is to not try to "not violate HIPAA" – that's easy and too low of a bar.
The real key is to not piss off the carpetwalkers: I don't want to have to defend myself in a meeting with Risk Management. Instead, I want to maintain a general profile I can defend to my dean and my department chair (and maybe someday to the promotion & tenure committee).

Twitter is a Giant Elevator
My big overall philosophy is that social media is like talking on an elevator. But: my mom, department chair, medical school dean, the patients' family, and a million other people are in the elevator. Obviously that doesn't mean that I'm always banal and polite. Rather, I recognize that people will see what I write and it is always tied to me.

Patient Privacy
Easy version: never talk about real patients.

Slightly tougher but still easy: if I do want to talk about real patients, I change enough of the details so that if the actual patient were to see it, the patient wouldn't recognize that it was them.

Two mistakes people make: date of service and age over 90 are HIPAA-protected PHI. The number one thing I do if I am referencing something that happened to a real patient is that I don't do it the same day (or even the same week).

I never even reference "oh look what happened on my drive to work today" so there can't be a real connection between anything I say and a real patient. And I don't share pictures from work or of patients without all of my ducks in a row (if at all).

On Anonymity
I'm not opposed to being anonymous, but I'm very much intentionally not. This is partially as a check on myself -- I know whatever I say is tied to me. A big part of it is to avoid the fear of people discovering my secret identity.

I'm not recommending anyone be anonymous on social media, but if I were, I would tell all my relevant bosses (e.g. program director, chair). If something serious "goes down," i.e. there's some sort of scandal, and it's a total surprise and secret to everyone, I imagine that there will likely be a big sense of betrayal.

But I don't want to be anonymous, it means you are giving up a lot of the upside. There are legitimate career, academic, and potentially financial benefits to being active on social media as a medical professional. I imagine all of that is possible but a lot harder if anonymous.

Hyponatraemia and Renal Replacement Therapy

A 63 year old woman was admitted to the ICU from the Emergency Department with acute alcohol withdrawal, severe hyponatraemia (serum sodium level 114mmol/L), rhabdomyolysis (creatine kinase 46930u/L) and acute kidney injury (serum creatinine 262umol/L, urea 8.7mmol/L, potassium 4.6mmol/L, base excess -6.8 and anuric from the point of admission). Her corrected calcium level was 1.92mmol/L. She […]

CJEM Infographic: Comparison of Sacco vs START triage using a virtual reality scenario with paramedic students

1This month CanadiEM is features an article recently published in the Canadian Journal of Emergency Medicine (CJEM) that compares the Sacco and START triage methods.2 The START (Simple Triage and Rapid Treatment) triage method is the most commonly used triage method worldwide and sorts patients based on their vitals and ability to walk. By contrast, the Sacco triage method is a newly developed system that sorts patients based on their vitals and available resources. ...

Author information

Simon Huang

Simon Huang

Simon Huang is a 1st year medical student at the University of Saskatchewan. Prior to starting medical school, he completed his Masters in Biochemistry at McMaster University. He is currently involved in infographic creation for CanadiEM and CJEM.

The post CJEM Infographic: Comparison of Sacco vs START triage using a virtual reality scenario with paramedic students appeared first on CanadiEM and was written by Simon Huang.